Takuji Iwashita1, Yousuke Nakai2, Tsuyoshi Mukai3, Osamu Togawa4, Saburo Matsubara5, Yuichiro Hatano6, Akira Hara6, Mariko Tanaka7, Junji Shibahara8, Masashi Fukayama7, Hiroyuki Isayama2, Ichiro Yasuda9. 1. First Department of Internal Medicine, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan. takuji@w7.dion.ne.jp. 2. Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 3. Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan. 4. Department of Gastroenterology, Kanto Central Hospital, Tokyo, Japan. 5. Department of Gastroenterology, Tokyo Metropolitan Police Hospital, Tokyo, Japan. 6. Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu, Japan. 7. Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 8. Department of Pathology, Kyorin University Faculty of Medicine, Tokyo, Japan. 9. Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Kawasaki, Japan.
Abstract
BACKGROUND: The necessity of histological analysis is increasing. A 19-gauge histology needle (PC19) in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has recently been developed and has shown high yields of tissue acquisition and histological diagnosis. AIMS: To compare the histological diagnostic yield in single-pass EUS-FNA for solid lesions using PC19 and a standard 19-gauge needle (EC19). PATIENTS AND METHODS: Consecutive patients with solid lesions were enrolled and underwent one pass with each of PC19 and EC19 for EUS-FNA with the randomized order of the needles. The primary endpoint was the histological diagnostic accuracy. The secondary endpoints were the feasibility, yield of histological core, cytological and overall diagnostic accuracies, and adverse events. Subgroup analysis was performed for the optimal situation with PC19. RESULTS: Of the 115 patients, 110 underwent EUS-FNA and five were excluded. EUS-FNA was performed from the esophagus in four, stomach in 80, or duodenum in 26. The final diagnosis was malignancy in 100 and benign in 10. The feasibility was 98.2 and 97.3% with PC19 and EC19, respectively (p = 1.00). The rate of presence of a histological core and the histological, cytological, and overall diagnostic accuracies for PC19 versus EC19 were 84.6 versus 80.9% (p = 0.593), 83.6 versus 73.6% (p = 0.099), 63.6 versus 56.4% (p = 0.335), and 90.0 versus 79.1% (p = 0.039), respectively. PC19 was favored in the trans-esophageal/gastric approaches to obtain a histological diagnosis (p = 0.013). Adverse events were observed in four patients. CONCLUSION: Single-pass EUS-FNA with PC19 was feasible and showed significantly higher overall diagnostic accuracy and an increased tendency towards histological diagnostic accuracy, especially with trans-esophageal/gastric FNA.
RCT Entities:
BACKGROUND: The necessity of histological analysis is increasing. A 19-gauge histology needle (PC19) in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has recently been developed and has shown high yields of tissue acquisition and histological diagnosis. AIMS: To compare the histological diagnostic yield in single-pass EUS-FNA for solid lesions using PC19 and a standard 19-gauge needle (EC19). PATIENTS AND METHODS: Consecutive patients with solid lesions were enrolled and underwent one pass with each of PC19 and EC19 for EUS-FNA with the randomized order of the needles. The primary endpoint was the histological diagnostic accuracy. The secondary endpoints were the feasibility, yield of histological core, cytological and overall diagnostic accuracies, and adverse events. Subgroup analysis was performed for the optimal situation with PC19. RESULTS: Of the 115 patients, 110 underwent EUS-FNA and five were excluded. EUS-FNA was performed from the esophagus in four, stomach in 80, or duodenum in 26. The final diagnosis was malignancy in 100 and benign in 10. The feasibility was 98.2 and 97.3% with PC19 and EC19, respectively (p = 1.00). The rate of presence of a histological core and the histological, cytological, and overall diagnostic accuracies for PC19 versus EC19 were 84.6 versus 80.9% (p = 0.593), 83.6 versus 73.6% (p = 0.099), 63.6 versus 56.4% (p = 0.335), and 90.0 versus 79.1% (p = 0.039), respectively. PC19 was favored in the trans-esophageal/gastric approaches to obtain a histological diagnosis (p = 0.013). Adverse events were observed in four patients. CONCLUSION: Single-pass EUS-FNA with PC19 was feasible and showed significantly higher overall diagnostic accuracy and an increased tendency towards histological diagnostic accuracy, especially with trans-esophageal/gastric FNA.
Authors: Peter B Cotton; Glenn M Eisen; Lars Aabakken; Todd H Baron; Matt M Hutter; Brian C Jacobson; Klaus Mergener; Albert Nemcek; Bret T Petersen; John L Petrini; Irving M Pike; Linda Rabeneck; Joseph Romagnuolo; John J Vargo Journal: Gastrointest Endosc Date: 2010-03 Impact factor: 9.427
Authors: Stavros N Stavropoulos; Gene Y Im; Zahra Jlayer; Michael D Harris; Teodor C Pitea; George K Turi; Peter F Malet; David M Friedel; James H Grendell Journal: Gastrointest Endosc Date: 2012-02 Impact factor: 9.427
Authors: Tiing Leong Ang; James Weiquan Li; Andrew Boon Eu Kwek; Prem Harichander Thurairajah; Lai Mun Wang Journal: Endosc Ultrasound Date: 2019 Jul-Aug Impact factor: 5.628